“Effective” Requesting

Abstract

This scoping review found that there is a large literature on how to modify the process and manner of the request to increase family consent rates. Another important line of inquiry focuses on the psychological impact of the decision on the family. Although a scoping review does not attempt to synthesize results or draw evidence-based conclusions, the literature generally supports the intuitive expectations that compassionate and respectful care for the deceased and family, listening for and addressing family concerns, and an attitude to donation that is positive (but not solely procurement-focused) and is best for both consent rates and family well-being. Although the presumption is often that the primary objective of asking for family consent is to secure consent and donation, some ethical commentary on requesting consent emphasizes that this objective must be balanced with the parallel obligation to protect the psychological well-being of families. This places some constraints on the approaches used in family consent discussions.

An Integrated Psychosocial Model of Relatives' Decision About Deceased Organ Donation (IMROD): Joining Pieces of the Puzzle

“…Religious beliefs also reveal complex relationships with the expression of willingness to donate. All major world religions approve of donation, but subgroups with a religious tradition may disagree (Chandler et al, 2017 ). Public surveys have also revealed a better disposition to donate in non-religious individuals and subgroups with moderate religious implication when compared with sectors with high religious implication (Scandroglio et al, 2011 ; López et al, 2012 ).…”

“…Finally, the deceased's wishes about donation and their communication to the family play a central role in family decision. In fact, the deceased's wishes (known or imagined) are the most powerful and consistent predictor of family decision (Walker et al, 2013 ; Chandler et al, 2017 ). However, in the absence of the deceased's formal statement, the deceased's “real” wishes cannot be directly known.…”

“…As mentioned previously, specific sociodemographic groups may have different attitudes toward organ donation, which may condition their decision about organ donation of the deceased. In this sense, consent rates are lower in families with low socioeconomic level, low cultural level, and belonging to minority ethnic groups (de Groot et al, 2012 ; Chandler et al, 2017 ). Lack of information, religious fears, distrust of medical staff, and communication difficulties have been related to the negative disposition of these populations (Radecki and Jaccard, 1997 ).…”

“…There are also excellent recent reviews in this field. This is the case of the works of: Chandler et al ( 2017 ), which provides guidelines for “effective” requesting; Ralph et al ( 2014 ), dedicated to qualitative studies; Walker et al ( 2013 ), including both qualitative and quantitative empirical works; Siminoff et al ( 2013 ), who used a global point of view; de Groot et al ( 2012 ), focused on empirical, theoretical, and practical studies; and Simpkin et al ( 2009 ), centered on the evidence about modifiable factors influencing relatives' decisions.…”

Reimagining liver transplantation in South Africa: A model for justice, equity and capacity building – the Wits Donald Gordon Medical Centre experience

“…Scarcity of donor organs for transplantation is a problem worldwide, and South Africa (SA) is no exception. While donor scarcity here has been widely researched, [1,2] a lesser-known and often misunderstood phenomenon in SA is the challenge of providing effective and integrated transplant services across two socioeconomically disparate healthcare sectors. [3] Ideally, these services should be grounded within a framework that facilitates equal access to transplantation and optimises financial efficiency.…”